Basic Information
| Provider Information | |||||||||
| NPI: | 1457647885 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 686 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285410686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103462273 | ||||||||
| FaxNumber: | 9103461907 | ||||||||
| Practice Location | |||||||||
| Address1: | 7901 EMERALD DRIVE | ||||||||
| Address2: | STE 7 | ||||||||
| City: | EMERALD ISLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285492880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523546500 | ||||||||
| FaxNumber: | 2523545060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 06/23/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCHILSKY | ||||||||
| AuthorizedOfficialFirstName: | RANDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9103462273 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.